Chapter 14 Flashcards
What are the four elements of a PD diagnosis? (a, b, c, and d in the definition for PD)
Characterized by enduring personality patterns (involving behavior, thoughts, emotions, and interpersonal functioning) that are (a) extreme and deviate markedly from cultural expectations, (b) inflexible and pervasive across situations, (c) evident in adolescence or early adulthood and stable overtime, and (d) associated with distress and impairment. Although there are often telltale signs of personality psychopathology in childhood, clinicians do not usually consider a personality disorder diagnosis until late adolescence or adulthood when personality development is more complete.
What is the psychodynamic theory of etiology for antisocial PD?
According to psychodynamic approaches, faulty superego development may cause those with APD to experience little guilt; they are, therefore, more prone to frequent violation of moral and ethical standards. Thus, the personalities of people with APD are dominated by id impulses that operate primarily from the pleasure principle; they impulsively seek immediate gratification and show minimal regard for others. People exhibiting antisocial behavior patterns presumably did not adequately identify with their parents and thus did not internalize the morals and values of society. Additionally, frustration, rejection, or inconsistent discipline may have resulted in fixation at an early stage of development
What is the cognitive theory of etiology for antisocial PD?
Certain core beliefs, and the ways they influence behavior, are emphasized in cognitive explanations of APD. These core beliefs operate on an unconscious level, occur automatically, and influence emotions and behaviors. Beck and colleagues summarized typical cognitions associated with:I have to look out for myself, Force or cunning is the best way to get things done, Lying and cheating are OK as long as you don’t get caught, I have been unfairly treated and am entitled to get my fair share by whatever means I can, Other people are weak and deserve to be taken, I can get away with things, so I don’t need to worry about bad consequences. These thoughts arise from what Beck and colleagues refer to as a “predatory strategy.” Thus, the worldview of those with APD revolves around a need to perceive themselves as strong and independent so they can survive in a competitive, hostile, and unforgiving world.
What is learning theory of etiology for antisocial PD?
Learning theories suggest that people with APD (1) have inherent neurobiological characteristics that impede their learning, and DiD (2) lack positive role models that would help them develop prosocial behaviors. Thus, biology and environmental factors combine in unique ways to influence the development of APD; As we have seen, some researchers believe that learning deficiencies among individuals with APD are caused by the absence of fear or anxiety and by lowered autonomic reactivity. If so, is it possible to improve their learning by increasing their anxiety or arousal ability? In a now classic study, researchers designed two conditions in which those with APD and control participants performed an avoidance- learning task, with electric shock as the unconditioned stimulus. Under one condition, participants were injected with adrenaline, which presumably increases arousal; under the other, they were injected with a placebo. Those with APD receiving the placebo made more errors in avoiding the shocks than did controls; however, after receiving adrenaline, they tended to perform better than con- trols. These findings imply that those with APD are more able to learn from negative consequences when their anxiety or arousal is increased.
What are the options for treatment of antisocial PD?
Behavior Modification Programs, Cognitive Approaches, Intervention with Antisocial Youth, Medication (Usually only used when comorbid disorder is present)
Behavior Modification Programs (Treatment of Antisocial PD)
Sometimes used for those at risk of developing APD, including juvenile offenders with antisocial traits. The most useful treatments focus on decreasing deviant activities, combined with opportunities to learn appropriate behaviors and social skills. Historically, the use of material rewards has been fairly effective in changing antisocial behaviors under controlled conditions; Once the young people leave the treatment programs, however, they are likely to revert to antisocial activities
Cognitive Approaches (Treatment of Antisocial PD)
Because individuals with APD are often influenced by dysfunctional beliefs about themselves, the world, and the future, they may have difficulty objectively anticipating possible negative outcomes of their behaviors. Beck, Freeman, and their associates have advocated that therapists build rapport with clients with APD, attempting to guide clients away from thinking only in terms of self- interest and immediate gratification and toward higher levels of thinking. This might include, for example, recognizing the effects of one’s behaviors on others and developing a sense of responsibility. Because cognitive and behavioral approaches assume that antisocial behaviors are learned, treatment programs often target inappropriate behaviors by setting rules and enforcing consequences for rule violations; they teach participants to anticipate consequences of behaviors and practice new ways of interacting with other
Intervention with Antisocial Youth (Treatment of Antisocial PD)
Since longitudinal studies show that the prevalence of APD diminishes with age as individuals become more aware of the social and interpersonal consequences of their behavior, emphasis is placed on intervention with antisocial youth. Treatment programs often broaden the base of intervention to include not only young clients but also their families and peers. Because people with antisocial traits often seek thrills, they may respond to intervention programs that provide the physical and mental stimulation they need
Medication (Treatment of Antisocial PD)
Current treatment options for people with APD are only minimally effective. Although medication is usually used only when there are comorbid conditions such as depression or substance abuse, a recent study showed promising results with the use of clozapine (an atypical antipsychotic) to reduce impulsive and violent behaviors in a small sample of violent men with APD incarcerated in a high- security hospital setting
What are the criticisms of the categorical model for PDs?
An exclusive categorical approach has limitations because categorical diagnoses (1) are based on arbitrary diagnostic thresholds, (2) use an all-or-none method of classification, and (3) do not take into account the continuous nature of personality traits. In reality, people often have personality traits in varying degrees or at various times. Also, we all exhibit some of the traits that characterize personality disorders—for example, suspiciousness, dependency, sensitivity to rejection, or compulsiveness—but not to an extreme degree. Alternative methods of determining personality psychopathology have been proposed as a response to these diagnostic issues.
